The Role of Nutrition and the Gut-Brain Axis in Psychiatry: A Literature Review

Individuals suffering from psychiatric disorders experience high levels of illness burden and a significantly reduced quality of life. Despite targeted psychopharmacological strategies and complementary psychotherapeutic procedures only moderate effects are obtained, and the risk of relapse is high in many patients. This narrative review highlights the important role of nutrition in psychiatric care and underlines the significance of nutritional advice in the multifactorial, biopsychosocial treatment of patients. It focuses on current dietary interventions such as the Mediterranean diet, dietary supplements and modifications of the gut microbiota with pre-, pro- and postbiotics.

Introduction to nutrition and the gut-brain axis

Worldwide, psychiatric diseases such as depression are continuously increasing, challenging the personal life of the affected as well as their families, but also whole societies by increasing disability, early retirement and hospitalization. According to current scientific knowledge psychiatric disorders are caused by a multifactorial pathogenesis, including genetics, inflammation and neurotransmitter imbalance; furthermore, also lifestyle-associated factors gain rising importance. In line with this, there is growing evidence that the gut microbiota and nutrition have an impact on the onset and course of psychiatric disorders.

Recent studies support the connection between the quality of diet, gut microbiota and mental health through regulation of metabolic functions, anti-inflammatory and antiapoptotic properties and the support of neurogenesis. Dietary coaching to improve mental health seems to be an additional, cost-effective, practical, nonpharmacological intervention for individuals with psychiatric disorders.

Driven by rapid urbanization, our lifestyle and food changed drastically in the last decades: traditional lifestyles (including social community structures, physical activity and diet) changed in a relatively short period of time. These changes are related to the high prevalence of depression and other psychiatric disorders in western, urbanized countries. In line with this, diet and nutrition are viewed as an important factor contributing to the pathogenesis of somatic as well as psychiatric disorders. As inhabitants of the western urbanized countries, we see ourselves confronted with the following paradox: despite the nearly unlimited availability of food, we often favor nutrient-poor, energy-dense, genetically modified and processed food. As a result, many of us are overfed and undernourished. Even though the calorie counts are rising, we do not meet the nutritional recommendations.

This study, published in Neuropsychobiology, underlines the important role of nutrition in psychiatric care to emphasize the need of an extended biopsychosocial treatment strategy which includes nutritional interventions as for the prevention and treatment of psychiatric disorders and to strengthen the emerging discipline of nutritional psychiatry

In this article you will learn:

2. Dietary Supplements: a combination of micronutrients and macronutrients that fits the body’s natural physiological needs and represents the full range of nutrients in whole foods may be more effective than a supplementation with isolated nutrients alone.

3. Gut Microbiome and the Gut-Brain Axis – The Bacteria in Our Gut and Their Importance to (Mental) Health: Dietary approaches could alter gut bacteria and gut bacterial metabolites such as short chain fatty acids, decrease cytokine production, lower overall inflammation and enhance the effect of current psychopharmacological approaches.

4. Pre, Pro and Postbiotics: The effects of psychopharmacological treatment on the microbiome have not been widely studied so far, but there are indications that these may exert antibiotic properties and thus have lasting effects on the gut microbiome.

5. Outlook: Multifactorial diseases need multifactorial approaches.

Conclusion / The use of nutritional interventions in psychiatry equips therapists with a promising tool for both the prevention and treatment of psychiatric disorders. Besides pharmacological therapy, psychotherapy and physical activity, nutritional interventions are an important pillar in the multifactorial, biopsychosocial treatment of psychiatric disease and could be used as a potential therapeutic target.